Foundations in OH – MetamOrpHosis From Caterpillar to Pupa

By Lucy Kenyon

Published 23 May 2023

How a series of workshops became a Foundation programme in Occupational Health

By Lucy Kenyon

From caterpillar to pupa

My journey to developing and delivering the ‘Foundation in Occupational Health’ course for the NHS National Performance Advisory Group (NPAG) has mirrored Kahlil Gibran’s quote: “A traveller I am, and a navigator, and every day I discover a new region within my soul”. (Gibran, 1923)

Like so many OH nurses of my generation, I ‘fell’ into the speciality when I took a foundry health surveillance and treatment role in the Midlands, on leaving London for Madchester in 1992 – Rave on!  It was here that I first experienced professional mentorship and practice teaching from an inspirational manager. She supported me when management questioned my well-intentioned response to a threatened midnight walk-out in the ‘melt’ area during the heat wave of 1995.  Having read through the instruction leaflet on our vintage wooden whirling hygrometer, I visited and measured the ambient temperature in the area. She also encouraged me to write a report to head office when I noticed a sudden increase in shoulder injuries in the loading bay. I met my husband over the corporate binding machine.

During the 1980s and ’90s, despite evidence that promoting health reduced healthcare costs (O’Brien, 1995), employers started to question the economic merits of OH and demanded a more commercial focus from OH. The OH activities in demand included recommending cost-efficient activities and alternate programs such as budgeting and cost-benefit analysis (Martin, 1993; Lusk, 1988). Nurses needed to upskill in the commercial aspects of workplace health! Arguments for efficiency alongside safeguarding clinical autonomy are counter-productive for patient outcomes. This led to a push for a new focus on professional education.

Despite the evidence that apparent threats to employees’ job security can have harmful health effects (Kuhnert, 1992), OH activities increasingly became integrated into employers’ sickness absence management policies and practices. Employers’ expectations of health outcomes have been endearingly named ‘sprinkling of fairy dust’ and ‘crystal ball gazing’ by the OH community. By 2015, nothing had changed. The newly forming Faculty of Occupational Health Nursing (FOHN) had reported that “Occupational health nurses were graduating from NMC accredited courses with very mixed levels of experience, knowledge and skills”. (FOHN, 2015)

From pupa to butterfly

Since 1996 I have had the privilege of teaching and mentoring pre- and post-registration and post-graduate students in OH, across a range of professional and academic institutions. I still treasure the letter – feedback – I received from my very first practice student.

To ensure my skill and confidence, I self-funded for the post-graduate OH and BOHS (British Occupational Hygiene Society) accredited hygiene qualification that taught the technical and scientific learning that I needed. From this, I developed and delivered my in-house professional training.

I was, delighted to be approached by the National Performance Advisory Group (NPAG) during the 2015 Health and Wellbeing at Work conference to review their existing sickness absence management workshop and develop and deliver a series of one-day ‘clinical professional development workshops on OH topics. The timing was also perfect to incorporate the learnings from AOHNP’s (now iOH) involvement in the 2016 NMC consultation to develop the reflective practice framework for revalidation.

Building the foundations

To get started, I reviewed the availability of skills-based courses and developed a series of 8 workshops that I believe fill the gaps in practical knowledge, competence and confidence of health professionals entering the field of OH. These continue to evolve through feedback and our inter-professional approach with distinctive learning outcomes that enable experienced delegates to participate in supervision and mentorship.

Employment & Pre-Placement Health Assessment seeks to improve job-person fit and reduce the risk of failed probationary periods.

Fitness for Work explores the statutory and evidence-based risk reduction measures associated with underlying health conditions.

Occupational Health Risk Assessment examines the individual risks experienced by disabled and other vulnerable workers as defined by the HSE, systematic reviews and emerging evidence.

COSHH Health Surveillance & Case Management explores the evidence and criteria of statutory screening and testing techniques for health assessment, protection, education, reporting and monitoring from pre-placement to post-exposure.

Noise and Vibration Health Surveillance & Case Management explores the application of evidence, criteria, and techniques for statutory health assessment, protection, education and reporting from pre-placement to post-exposure.

Human Factors in OH, Ergonomic Assessment & Adjustments investigates the common workplaces and activities where OH assessments are likely to have a beneficial impact on health outcomes.

Long-Term Condition, Health & Disability Management explores the high prevalence impairments within the working population and supported-self management approaches to reduce risk.

Performance & attendance at work explores the hidden disabilities that can cause impairments within the workplace or the context of work and strategies that individuals and employers can apply to reduce or remove the disadvantage caused by those impairments.

Each of the workshops has its own reading list, agenda, case studies, practical sessions and course slides to enable each delegate to continue to reflect, research, and build confidence and competence to grow in their role.


I’m excited for the future of OH as the National School of Occupational Health focuses on developing the OH workforce and the opportunity to consolidate the experiences and learnings of the last 8 years with NPAG. My ability to flex and adapt to future needs has been tested when migrating from an in-person to a virtual learning environment overnight in 2020. I have enjoyed learning and growing from meeting fellow OH nurses taking part in participatory CPD and the diverse spectrum of multi-disciplinary professionals including nurses, occupational therapists, physiotherapists, psychologists and radiographers seeking a career in OH at all stages of practice joining or serving NHS and private sector employers across the compass of the UK.



Lucy Kenyon is a Specialist OH Nurse Consultant who has been teaching and mentoring Occupational Health since 1996 for the RCN, Universities of Birmingham, Coventry, Derby and West of Scotland. She delivers professional development courses for the National Performance Advisory Group, Cordell Health and employers, for whom she researches and develops evidence-based practice. 

She has been a member of the iOH board since 2014 and became VP before accepting the role of President in 2017 till 2020. She has been a Non-Executive Director since 2021.

Lucy is an independent OH practitioner and is primarily involved in delivering OH services to small and medium-sized companies. She has a special interest in applying modern technologies to improve employee health, safety and wellbeing outcomes. She has a Master of Medical Science and an International Certificate in Occupational Hygiene from Birmingham, where she has taught and worked on research projects.

Lucy is a keen singer and musician and has served as a school governor, community charity trustee and volunteer for local youth, fostering and neuro-diversity groups.


OH Today Spring 2023
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